局限性紫癜性肝病计算机断层扫描与磁共振成像特征分析

Analysis of the characteristics of computed tomography and magnetic resonance imaging of focal peliosis hepatis

目的探讨局限性紫癜性肝病(PH)的计算机断层扫描(CT)与磁共振成像(MRI)特征。方法选择2015年1月1日至2022年12月31日于乐清市人民医院经病理确诊的8例PH患者(10个病灶),分析病灶部位、大小、形态等,以及患者的CT(4例患者4个病灶)与MRI(5例患者7个病灶)特征。采用描述性方法进行统计学分析。结果8例PH患者中,6例患者病灶位于肝右叶,1例位于肝左叶,1例(3个病灶)位于肝左、右叶;8个病灶呈圆形或类圆形,2个病灶呈片状不规则形。病灶中位最大径(范围)为4.2 cm(2.2~9.3 cm),其中2个病灶最大径<3.0 cm,6个最大径为3.1~5.0 cm,2个最大径>6.0 cm。9个病灶界限清晰,1个界限模糊。9个病灶有包膜,1个无包膜。1个病灶内有血管穿行。4例患者(4个病灶)CT平扫显示,3个病灶密度均匀,3个病灶呈低密度;CT增强扫描显示,动脉期2个病灶呈显著强化,门脉期3个病灶持续中度强化,延迟期2个病灶持续轻度强化。5例患者(7个病灶)MRI平扫显示,6个病灶信号均匀,T1加权像3个病灶呈低信号、4个呈等信号,T2加权像压脂序列6个病灶呈高信号,弥散加权成像3个病灶呈高信号、4个呈等信号;MRI增强扫描显示,4个病灶动脉期全瘤显著强化,5个病灶门脉期持续中度强化,6个病灶延迟期持续轻度强化。结论PH病灶呈圆形或类圆形,界限清或不清,密度均匀或不均,CT和MRI平扫特征为低密度,T1加权像低信号,T2加权像和弥散加权成像高信号,CT和MRI增强以中度或显著持续强化为特征。

ObjectiveTo investigate the characteristics of computed tomography(CT)and magnetic resonance imaging(MRI)of focal peliosis hepatis(PH).MethodsFrom January 1,2015 to December 31,2022,a total of 8 PH patients(10 lesions)diagnosed pathologically in Yueqing People′s Hospital were collected.The location,size,and shape of the lesions,as well as the CT(4 patients with 4 lesions)and MRI(5 patients with 7 lesions)characteristics of the patients were analyzed.Descriptive method was used for statistical analysis.ResultsAmong the 8 PH patients,6 patients had lesions located in the right lobe of the liver,1 in the left lobe of the liver,and 1(3 lesions)in both left and right lobes of the liver.Eight lesions were round or round-like,and 2 lesions were irregularly shaped.The median maximum diameter of the lesions was 4.2 cm(ranged from 2.2 to 9.3 cm),of which the maximum diameters of 2 lesions were less than 3.0 cm,those of 6 lesions were 3.1 to 5.0 cm,and those of 2 lesions were more than 6.0 cm.Nine lesions had clear boundaries,and 1 lesion had blurred boundary;9 lesions had capsule,1 lesion had no capsule;1 lesion had blood vessels passing through it.The CT plain scan of 4 patients(4 lesions)showed that 3 lesions had uniform density and 3 lesions had low density,the CT enhancement showed that 2 lesions were significantly enhanced in the arterial phase,3 lesions were sustained moderately enhanced in the portal phase,and 2 lesions were sustained mildly enhanced in the delayed phase.The MRI plain scan of 5 patients(7 lesions)showed uniform signals in 6 lesions,low signal in 3 lesions and equal signal in 4 lesions on T1-weighted images,high signal in 6 lesions on T2-weighted images,high signal in 3 lesions and equal signal in 4 lesions on diffusion-weighted images.The MRI enhancement showed that 4 lesions were significantly enhanced in the arterial phase,5 lesions were sustained moderately enhanced in the portal phase,and 6 lesions showed sustained mild enhanced in the delayed phase.ConclusionThe PH lesions are round or round-like,with clear or unclear boundaries and uniform or uneven density,and are characterised by low density on CT and MRI plain scan,low signal on T1-weighted images,and high signal on T2-weighted images and diffusion-weighted images,and moderate or significant sustained enhancement on CT and MRI enhancement.